Top 8 things To Do To Get Through Perimenopause

Perimenopause can feel confusing, frustrating, and unpredictable, bringing symptoms that affect everything from sleep and mood to weight and energy levels. You’re eating the same way you always have, exercising regularly, and trying to get enough sleep. Yet, you’re gaining weight, waking in the middle of the night, and feeling more irritable than ever.

If this sounds familiar, you’re not alone. In fact, this hormonal transition can begin years before menopause and affect everything from metabolism and mood to sleep, muscle mass, and heart health.

The good news? Research shows that nutrition, movement, sleep, stress management, and targeted lifestyle support can significantly improve symptoms and long-term health outcomes. As a result, the right strategies can help stabilize energy, improve mood, support metabolism, preserve muscle and bone health, and reduce inflammation.

With that in mind, in this article, we’ll share 8 science-backed things you can do to support your body through perimenopause and why they matter.

What is Perimenopause?

So what exactly is perimenopause? Perimenopause is the transitional phase leading up to menopause, and it often begins years before periods stop. During this time, estrogen and progesterone levels fluctuate unpredictably. As ovulation becomes less consistent, these hormone shifts can affect nearly every system in the body.

In fact, for many women, symptoms can start as early as their late 30s or early 40s and continue into the 50s.

In fact, progesterone is the first hormone to decline. With this decline, ovulation becomes more irregular and can result in irregular and heavy bleeding. This can begin in the late 30s. As a result, this drop can contribute to sleep disturbances, mood changes, and changes in fertility.

Symptom Category	Commons Symptoms
Physical	weight gain, changes in body composition, joint and muscle pain, fatigue, cardiovascular and metabolic changes, hair and skin changes
Menstrual	irregular cycles, skipped periods, heavier or lighter periods
Vasomotor	hot flashes and night sweats
Psychological	mood swings, irritability, anxiety, and new or worsening depression
Cognitive	brain fog, memory changes, and trouble concentrating
Genitourinary	low libido, urinary frequency or incontinence, painful intercourse, and vaginal dryness

Importantly, these symptoms are not just normal signs of aging. Rather, they are a physiological responses to hormonal changes that affect metabolism, insulin sensitivity, inflammation, stress hormones, and neurotransmitters.

Because of this, supporting your body during this phase can make a meaningful impact on how you feel now and long-term health after menopause.

1. Best Nutrition Strategies for Perimenopause

Nutrition is one of the most powerful tools for managing perimenopause symptoms because hormonal changes affect how the body regulates blood sugar, stores fat, builds muscle and manages inflammation.

As estrogen and progesterone levels fluctuate, many women experience increased insulin resistance, changes in appetite regulation, and muscle loss. Consequently, these shifts can make weight gain feel sudden or unexplained, even when eating habits have not changed.

Rather than focusing on restriction or dieting, the goal is to support blood sugar stability, preserve lean muscle mass, protect bone health, reduce inflammation, and provide the nutrients needed for hormone support.

Blood Sugar Balance: Why is Matters During Perimenopause

As estrogen levels fluctuate during perimenopause, many women experience changes in insulin sensitivity and blood sugar regulation. Consequently, blood sugar levels may become more difficult to manage, leading to symptoms such as:

• Energy crashes
• Increased cravings
• Mood swings
• Difficulty concentrating
• Increased hunger

Over time, repeated blood sugar spikes and crashes can also contribute to increased insulin resistance and changes in body composition, especially around the midsection.

Fortunately, some simple nutrition strategies can help support more stable blood sugar levels. For instance:

• Include protein at every meal and snack
• Choose fiber rich carbohydrates such as fruit, vegetables, beans and whole grains
• Pair carbohydrates with a protein and/or healthy fat
• Avoid skipping meals
• Stay active throughout the day with movement breaks

Building meals around protein, fiber, and healthy fats can help support energy levels, improve satiety, and reduce cravings throughout the day.

In practice, a helpful tip is to look at your plate to make sure at every meal there is: Protein + Fiber + Healthy Fat. This combination helps with energy, reduces cravings, and supports metabolism.

Prioritize Protein

As estrogen declines, muscle loss accelerates, which can slow metabolism and affect energy levels.

Specifically adequate protein intake can help:

• Maintain lean muscle mass
• Improve metabolism
• Support appetiate
• Stabilize blood sugar
• Reduce cravings and energy crashes

Aim to include 25 – 30 grams of protein at per meal:

• Greek yogurt
• Eggs
• Fish
• Chicken and Turkey
• Tofu or tempeh
• Cottage cheese
• Beans and lentils

Many women unintentionally underconsume protein at breakfast and lunch, which can lead to afternoon fatigue and cravings. As a result, they may find it harder to maintain steady energy levels throughout the day.

Increase Fiber Intake

Fiber plays a critical role in gut health, cholesterol regulation, and blood sugar balance. It also supports estrogen metabolism through the gut microbiome. This is also known as the estrobolome, a subset of specific bacteria in your gut that metabolizes estrogen.

To support these benefits, aim to include 25 – 30 grams per day from whole foods:

• Vegetables
• Fruits
• Beans and legumes
• Nuts and seeds
• Whole grains

Support Bone Health with Calcium and Vitamin D Rich Foods

Declining estrogen accelerates bone loss, increasing the risk of osteoporosis. Because of this, calcium intake becomes especially important during perimenopause.

Therefore, aim for 1,000 to 1,200 mg of calcium per day from:

• Milk and yogurt
• Cottage cheese
• Tofu and edamame
• Sardines and canned fish with bones
• Fortified plant based milks
• Dark leafy greens

Additionally, pairing calcium rich foods with adequate vitamin D is essential for calcium absorption and bone strength. Aim for 800 – 1,000 IU a day from food sources when possible.

Focus on Anti-inflammatory Foods

Additionally, chronic inflammation may contribute to an increase in symptoms like joint pain, fatigue, and increased cardiometabolic risks. For this reason, aim to include anti-inflammatory foods daily.

• Fatty fish
• Nuts and seeds
• Extra Virgin Olive oil
• Berries
• Leafy Greens
• Herbs and spices like ginger and turmeric

Reduce Ultra-Processed Foods

Highly processed foods can increase inflammation and can contribute to unstable blood sugar. As a result, symptoms such as fatigue, irritability, and cravings may worsen.

However, the goal is not perfection or complete elimination.

Instead, focus on building a consistent foundation of nutrient dense meals most of the time, while allowing flexibility to enjoy some of time. It is not about cutting foods out, it is about what you consistently include.

Balanced Plate:

• Grilled fish or chicken (protein)
• Roasted vegetables (fiber, micronutrients)
• Sweet potato or quinoa (complex carbohydrate)
• Olive or avocado oil (healthy fat)

A plate like this helps stabilize blood sugar, support energy, and reduce cravings later in the day. In addition, it provides key nutrients that support overall health during perimenopause.

Common Nutrition Mistakes in Perimenopause

Many women unknowingly make changes that can worsen symptoms, like:

• Skipping meals, especially breakfast
• Eating too little calories
• Cutting out most carbohydrates
• Not drinking enough water and fluids
• Exercising, especially cardio while under eating protein

Ultimately, nutrition during perimenopause is not about restriction or dieting. Small, consistent shifts in protein intake, fiber, and whole foods can significantly improve metabolism, energy and overall health.

2. Exercise During Perimenopause

Exercise during perimenopause is not just about weight management. More importantly, it is one of the most powerful tools for supporting healthy aging, preserving independence, and maintaining overall quality of life.

As estrogen declines, women begin to lose muscle mass and bone mass at a faster rate. These changes can contribute to a slower metabolism, reduced strength, and an increased risk of osteoporosis and injury. Fortunately, regular physical activity can help counteract these effects. In addition, exercise supports long-term mobility and independence.

Strength Training is Essential

Strength training is one of the most effective forms of exercise during perimenopause. Research consistently shows resistance training can help:

• Preserve and build lean muscle mass
• Improve insulin sensitivity
• Support metabolism
• Protect bone density
• Improve mood and energy

Ideally, aim for 2 – 4 strength training sessions per week. This can include free weights, resistance bands, bodyweight exercises, or machine-based workouts.

Don’t Forget Cardiovascular Movement

In addition to strength training, regular cardio supports heart health, energy levels and stress management.

• Walking
• Swimming
• Cycling
• Dancing
• Hiking
• Low impact fitness classes

Furthermore, current guidelines recommend at least 150 minutes of moderate-intensity aerobic activity a week.

Even simple habits can make a difference. For example, walking for 10 minutes after meals can help improve blood sugar regulation, digestion, and daily movement goals.

More is Not Always Better

Many women respond to perimenopause weight gain by increasing high intensity exercise. While increasing movement can be beneficial, more exercise is not always better.

Excessive training combined with poor recovery can increase fatigue, elevate stress hormones, and make it more difficult to maintain consistent exercise habits. Therefore, recovery should be viewed as an essential part of any exercise routine.

Instead, focus on a more balanced approach:

• Strength training
• Cardio
• Stretching
• Jump training
• Rest and recovery days

Additionally, adding yoga, Pilates, and stretching can help improve flexibility, reduce stress, and support recovery between workouts.

Ready to get started, but are unsure how? Our personalized fitness plans are designed to help you build strength, improve energy, and achieve your overall wellness goals. Whether you are a beginner or a fitness enthusiast, our personal trainers can create a customized plan to help you reach your goals.

3. Sleep and Perimenopause

Sleep changes are one of the most common complaints during perimenopause. Hormonal fluctuations can affect body temperature, cortisol, blood sugar regulation, and melatonin production. As a result, many women experience difficulty falling asleep, staying asleep, or waking up feeling rested. Consequently, sleep quality becomes a major factor in overall well-being.

Unfortunately, poor sleep can worsen:

• Cravings
• Insulin resistance
• Mood swings
• Weight gain
• Brain fog

Tips for Better Sleep

To support better sleep quality, consider these strategies:

• Create a consistent sleep routine
• Limit alcohol before bed
• Reduce evening screen exposure
• Support blood sugar
• Keep bedroom cool

4. Understanding Hormonal Shifts

One of the most frustrating components of perimenopause is the unpredictability. Unlike menopause, which is defined as the absence of a period for 12 months, perimenopause is characterized by fluctuating hormone levels. Perimenopause can last up to 10 years.

Hormones do not decline in a straight line. Instead, estrogen can fluctuate dramatically from day to day, like a ping pong ball or being on a never-ending rollercoaster.

Consequently, these shifts can affect:

• Mood and energy level
• Appetiate
• Metabolism
• Sleep
• Skin
• Hair

Why Belly Fat Increases

Additionally, many women notice changes in body composition during menopause. Declining estrogen changes fat distribution patterns, making women more likely to store fat around the abdomen. Importantly, this is not a willpower issue or “just eat less and move more”.

Rather, factors like stress, poor sleep quality, insulin resistance, and muscle loss also contribute to these changes. Furthermore, hormones influence more than reproductive health.

Most people think of estrogen’s role in reproduction. However, estrogen receptors are found throughout the body, which is why hormone fluctuations can have such widespread effects.

Therefore, understanding these hormone shifts helps women move away from self-blame and focus on supportive, sustainable strategies instead.

Estrogen influences:

• Brain function
• Bone health
• Cardiovascular health
• Insulin sensitivity
• Inflammation

5. Stress Management During Perimenopause

Stress management during perimenopause is an important part of reducing symptoms and supporting overall health.

Chronic stress can increase cortisol levels, which may disrupt sleep, increase cravings, weight gain, and worsen mood symptoms. Therefore, finding effective ways to manage stress is important to overall well being.

Strategies to Support Stress Management

• Gentle movement like yoga or tai chi
• Social connections with friends and family
• Setting boundaries to balance self care and day to day responsibilities
• Blood sugar regulation with balanced meals and snacks

6. Supplements for Perimenopause

In addition to nutrition, movement, sleep and stress management, certain supplements may provide additional support during perimenopause.

However, supplements are not a magic solution. Instead, they can compliment nutrition, sleep, exercise, and stress management.

Supplements needs can vary from person to person. Factors like, dietary intake, labs, medical history, medications, and individual symptoms should be considered when adding in a new supplement.

Creatine Monohydrate

Creatine is one of the most well researched supplements available and may be particularly beneficial during perimenopause when muscle mass and bone density naturally begin to decline.

Typical dose: 3-5 grams daily

Potential benefits include:

• Supporting muscle mass and strength
• Supporting bone mineral density
• Supporting mood and overall well being
• Supporting brain health and cognitive function

Vitamin D

Vitamin D plays an important role in bone health, immune function, and overall health. Because estrogen decline accelerates bone loss, adequate vitamin D intake becomes especially important during perimenopause.

General recommendation: 800 – 1000 IU daily via supplement, although individual needs may vary.

Potential benefits include:

• Supporting bone health
• Supporting immune function
• Supporting mood

Magnesium Glycinate

Typical dose: 300 – 600 mg a day (depending on supplement formulation)

Potential benefits include:

• Supporting sleep quality
• Supporting mood
• Supporting bone health
• Supporting muscle function

Omega-3 Fatty Acids

Omega-3 fatty acids are essential fats that support heart health, brain function, and inflammation. During perimenopause, omega-3 may help support support overall health and improve symptoms related to mood or inflammation.

Typical dose: 1,000 – 2,000 mg combined EPA and DHA daily

Potential benefits include:

• Supporting heart health
• Supporting brain and cognitive function
• Supporting mood
• Supporting healthy aging

Ashwagandha

Ashwagandha is an adaptogenic herb that may help support the body’s response to stress.

Typical dose: 300-600 mg daily (depending on supplement formulation)

Potential benefits include:

• Supporting mood
• Supporting stress management
• Supporting overall well being

Before starting any supplements, speak with your healthcare provider or registered dietitian to determine what is appropriate for your individual needs.

7. Mood Changes During Perimenopause

Mood changes can be one of the most common and least talked about symptoms of perimenopause. Many women experience feeling more irritable, anxious, frustrated, lack of motivation, feeling overwhelmed more easily and just not themselves.

Fluctuating estrogen and progesterone directly affect neurotransmitters in the brain, this includes serotonin, GABA, and dopamine. They play a key role in stress response, emotional resilience, and mood regulation.

Strategies to Support Mood

• Stress management practices like breathing, journaling, and mindfulness
• Prioritizing consistent, balanced meals for blood sugar regulation
• Regular strength training and walking for mood regulation
• Morning sunlight exposure to support circadian rhythm

However, for some women, symptoms may be more persistent and may benefit from additional support from a healthcare provider.

8. Hair and Skin Changes During Perimenopause

An unexpected and equally unwelcome change to skin and hair occurs during perimenopause. Declining estrogen and unpredictable hormonal balance can affect collagen production, hair growth cycles, and oil production.

More specifically, estrogen plays a role in maintaining collagen, hydration, and hair follicle health. Fluctuating and declining levels led to more visible changes.

Strategies to Support Hair and Skin

• Prioritize protein intake
• Omega 3 fatty acid to support skin hydration and reduce inflammation
• Vitamin C-rich foods to support collagen synthesis
• Staying well hydrated

At the same time, topical skincare and hair products can help, but internal support is often a crucial factor in improving skin and hair health.

Get Personalized Perimenopause Nutrition Support

Struggling with perimenopause symptoms like weight gain, low energy, poor sleep, difficulty managing muscle mass, or constant cravings? While these symptoms are common, they don’t have to become your new normal.

At Anderson’s Nutrition, our registered dietitians help women navigate perimenopause with evidence-based nutrition, meal planning, exercise guidance, and sustainable lifestyle strategies. We work with you to create a personalized plan that supports your energy, metabolism, strength, bone health, and overall well-being.

Regardless of where you are in your perimenopause journey, whether your goal is managing weight changes, improving sleep, increasing protein intake, building healthy habits, or simply feeling more like yourself again, we’re here to help!

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